The Haywood County medical community sent a strong message at a countywide meeting of doctors last Tuesday night (Dec. 12). In a 50 to 2 vote, physicians asked the hospital board of Haywood Regional Medical Center to reconsider their decision to replace emergency room doctors.

“The medical staff is very distraught over the potential loss of these very fine doctors,” said Robin Matthews, the medical chief of staff.

The hospital board, acting on the recommendation of hospital CEO David Rice, voted to terminate the contract of Haywood Emergency Physicians, a group of local doctors who run the emergency room, despite 18 months left on the contract. They will be replaced by a corporate physician staffing company with a lawsuit checkered past.

Doctors voted 50 to 2 to recommend that the hospital administration engage in a formal mediation process with the ER doctors to come to a win-win solution. Five doctors abstained from voting.

Doctors believe hospital CEO David Rice misled the hospital board to get rid of Haywood Emergency Physicians due to a long-running power struggle and personality conflict between Rice and some of the more outspoken ER doctors, namely Dr. Mark Jaben. After similar conflicts with Rice that led to the departure of the orthopedists and anesthesiologists two years ago, the medical community fears the hospital administration has developed a reputation of being hostile toward doctors, hurting efforts to recruit new doctors to the community.

A corporate physician staffing firm called Phoenix Emergency Physicians is slated to take over ER operations on Dec. 28. Phoenix has provided conflicting information on how many doctors they already have lined up to work at HRMC. Chris Lutes, the manager of Phoenix, told The Smoky Mountain News last Monday he already had eight doctors confirmed to work in the ER. But representatives of Phoenix who spoke at the countywide meeting of doctors the following evening said they only had two doctors confirmed so far, according to doctors who were in the meeting.

Emergency room doctors say they were blind-sided when they received a letter from the hospital terminating their services. They had disagreements with the hospital administration over proposed language in a new contract, but they believe they were still in the midst of negotiations over the language. They had met only once with hospital administration and once with the hospital board to discuss the contract when the hospital board voted to cancel it.

Hospital administration said they had reached a stalemate with the current group of ER doctors who were unwilling to compromise on anything. The main sticking point in the contract would have given Rice unilateral hiring and firing authority over the ER physicians without cause and no means for recourse by the doctors if they believe they were unfairly targeted. The ER doctors believe a loss of autonomy would interfere with patient care decisions, which can sometimes be contrary to the business interests of a hospital.

Other physician groups that have contracts to provide hospital-based services have agreed to such language, however.

The hospital board met in a special meeting Monday (Dec. 18) to “confer with legal counsel regarding the latest development in respect to the Emergency Department contract relationship,” according to a meeting notice from the hospital administration. The meeting was conducted in closed session.

The hospital board is meeting Thursday night, Dec. 21, which will be their last chance to postpone the ER take over on Dec. 28 by Phoenix and try for mediation with the current group of ER doctors as the medical community requested.